Letter to Health Canada Director Ronald Burke from Alliance for Food Label Reform: Amendments to Food and Drug Regulations concerning nutrition labelling, nutrition claims, and health claims published in the Canada Gazette, Part I on June 16, 2001.

The Alliance for Food Label Reform(1) would like to congratulate Health Canada and Minister
Rock for moving ahead with plans to introduce comprehensive food labelling reforms. We are
especially pleased with the decision to mandate that comprehensive nutrition information be reported on
most packaged foods in absolute values and as a percentage of the average recommended daily intake,
and that this information be displayed on labels in a uniform, easy-to-read format.

Benefits of food label reforms

Preventative health care is a forward thinking, cost-effective approach to enhancing the health
of the public. As Health Canada, and Agriculture and Agri-food Canada noted, poor diet is expected
to cost the Canadian economy more than $76 billion during the next two decades.(2) The proposed
reforms to food labelling rules are expected to generate $5 billion in net savings over the same period as
a result of declining premature deaths and disabilities due to cardiovascular disease, stroke, cancer, and
diabetes. These predicted cost savings contrast very favorably with the comparatively small $263 to
$357 million in costs to industry for implementing the label reforms.(3)

The opportunity and need for refinements to the proposal

The proposed amendments to the Food and Drug Regulations represent an opportunity for
fundamental reform of food labels, and all reasonable steps should be taken to optimize this opportunity
to capture benefits not accounted for in the Regulatory Impact Analysis Statement as published in the
June 16, 2001 Canada Gazette notice. For instance, the regulatory proposal should extend the scope
of mandatory nutrition labelling rules to encompass all fresh meat, poultry, seafood and in-store baked
goods  some of which are chief sources of heart-disease-promoting saturated and trans fats. This
review could also be used as an opportunity to require concise explanatory notes in nutrition claims to,
for example, prevent consumers from getting the false impression that low fat and low sugar foods
are necessarily also low calorie foods.(4)

It is also critical that the proposed regulatory amendments be revised to prevent the proliferation
of misleading claims  especially in connection with the proposed health claims which are currently
prohibited outright under Canadian law. While the Alliance for Food Label Reform has been a strong
advocate of mandatory, nutrition labelling, we have been concerned that some health and nutrition
marketing claims may deceive consumers and impair, rather than improve, the health status of
Canadians. Two of the five proposed health claims are of particular concern because they could mislead
consumers. For example, the osteoporosis risk reduction claim would, as proposed, be permitted on
foods that are high in heart-disease-promoting saturated fat. Putting the claim on these foods would
mislead the public and, rather than benefit the health of the public, it could increase the risk of other
diseases and undermine the credibility of the entire food label. Similarly, the cancer risk reduction claim
would be allowed on foods such as condiments, fruit jams, and fruit jellies that are high in sodium or
contain very little fruits or vegetables (the ingredients upon which the justification for the claim is based).
We urge that these shortcomings be remedied before the regulations are finalized, not after they have
caused problems.

Specific recommendations for improving the regulatory proposal

In particular, the proposed regulations could be vastly improved by taking the following
measures:

Close the loophole for labelling fresh meat, poultry, seafood, fruits and vegetables: If
necessary, Health Canada should provide a three year grace period for complying with
mandatory nutrition labelling rules for pre-packed, single-ingredient fresh meat, poultry, and
marine, freshwater animal products, fruits, and vegetables rather than exempting them outright
(i.e., delete proposed paragraphs B.01.401(2)(b)(ii), (iii) and (iv) and revise the transition
provisions in subsection 34(3) of the proposal accordingly).(5)

Do not exempt in-store baked goods: In-store baked goods (including desserts high in trans
and saturated fats, low-fibre breads, and high-calorie muffins) should not be exempt from the
general requirement to provide nutrition information. We urge Health Canada to limit the
proposed exemption for foods processed and prepared on-site at the retail premises (see
proposed paragraph B.01.401(2)(b)(vi)) to foods that are made to order at the request of
individual shoppers.

Ensure that nutrition information is provided on the basis of standardized serving sizes, not
ranges: Standardization of serving sizes makes it easier for consumers to make nutrient
comparisons among foods and ensures that companies do not use unrealistically small or large
serving sizes to favourably portray the nutritional composition of their products. While Schedule
M of the proposed regulations specifies standard reference amounts for 151 foods, it is not clear
that these will be used as the basis of nutrition labelling (rather than merely nutrition and health
claims). However, in October 2000, Minister Rock published Principles of Proposed Policy
for Nutrition Labelling which states, in part: Servings are based on Reference Amounts of
food which are standardized quantities reflecting the amount of a food consumed at a single
eating occasion. Reference amounts...will be included in the Food and Drug Regulations.(6)

Tighten rules for making health claims: Health Canada should tighten the eligibility rules for the
use of health claims  especially claims related to osteoporosis(7) and cancer(8)  so that only
foods low in saturated and trans fat, cholesterol, sodium, and added sugars would be eligible to
make such claims. Excessive consumption of these nutrients is linked to heart disease and some
forms of cancer, as well as obesity  which is a risk factor for diabetes and coronary heart
disease.

Another possible approach would be to require that, in the case of the calcium/vitamin
D-osteoporosis claim, a separate claim statement be used for products higher in saturated fat.
Under this approach, the claim statement should be worded so that parents will know to buy
different types of milk and other foods for their children (i.e., low fat for the adults and higher fat
for the children), or so parents will know to gradually switch the family back to lower saturated
fat dairy foods as their children reach the end of linear growth. Following this approach would
address Health Canadas concern that limiting the claim to low fat products may impair the bone
growth of children by indirectly decreasing their fat intake. We propose that high
calcium/vitamin D foods that have more than 2 grams of saturated fat be required to disclose in
the claim statement the amount of saturated fat in a serving of the food and advise adult
consumers to choose foods lower in saturated fat.(9)

Control the use of all health-related claims: All claims  including biological role claims,(10)
structure/function claims, and endorsements by 3rd party health charities  should be required to
satisfy the same standards for claim substantiation, safety, pre-market approval, and labelling as
those set out for health claims. These claims can be easily mistaken by consumers to be
authorized health claims and should, therefore, be required to meet the same high standards.

Conclusion

Health Canada has an opportunity to fashion new food labelling regulations that will deliver
maximum health benefits to Canadians and be regarded, by public health officials world-wide, as the
model to emulate  much like the current Canadian tobacco regulations. We urge Health Canada to
review its proposal with the objective of ambitiously advancing the publics health, in particular, by
ensuring that nutrition information is on as many foods as possible, including fresh meat, poultry, seafood,
and in-store baked goods. At a minimum, the federal government should not finalize weak eligibility
rules for the use of health claims that could promote unhealthful dietary practice and ultimately harm,
rather than benefit, the health of consumers.

If Health Canada can design health claims messages and eligibility criteria that send accurate,
useful messages to consumers which can truly assist them in selecting more healthful foods, it should
require all eligible foods to make all applicable claims on their labels. Voluntary health claims on a few
products may simply mimic the problems of voluntary nutrition labelling. By contrast, mandatory health
claims for all eligible foods would ensure that consumers have complete and consistent health information
about all foods that qualify to make claims.(11)

We also urge that Health Canada and the Canadian Food Inspection Agency have the funds
necessary to educate the public about the new labels, monitor compliance by manufacturers, and take
appropriate enforcement measures when necessary.

If we can be of any assistance to your office in addressing these concerns, please do not hesitate
to contact us at (613) 565-2140.

1. The Alliance for Food Label Reform is a coalition of 17 non-profit organizations representing
nearly two million consumers, scientists, physicians, nutritionists, and other health professionals from all
across Canada. The Alliance has urged Health Canada and Members of Parliament, since 1997, to
establish mandatory, comprehensive, easy-to-read nutrition information on all food labels and to
prevent the misleading use of health and nutrition marketing claims for foods.

2. This estimate includes the diet-related costs (expressed in 2000 dollars) anticipated over the
period 2002-2022 for only four diagnostic categories: cancer, diabetes, heart disease and stroke. See
Agriculture and Agri-food Canada, Costs and Benefits of Nutrition Information, (Ottawa: HC and
AAFC, May 2000) at 4.

4. For example, low fat claims should be accompanied, where appropriate, by the statement: Not a low calorie food.

5. In particular, the additional year (beyond the standard two year implementation period) will
give the meat industry sufficient opportunity to create accurate databases for the common cuts and
species of products. The use of nutrition information in advertisements and industry web-site marketing
information suggests much progress has already been made.

7. Under the current regulatory proposal, the calcium/vitamin D-osteoporosis claim would be
permitted on foods that are high in added sugars or heart-disease-inducing saturated fat (such as ice-cream, milk shakes, high fat cheeses, and homogenized milk). High levels of saturated fats increase the
risk of heart disease in the adults who might be drawn to the osteoporosis claims, thereby offsetting the
benefits to bone health. Claims should be prohibited on these foods or, if not, then the fact that they are
high in saturated or trans fat should be disclosed in the claim statement.

8. This claim raises two problems. First, it could be made about high sodium products, such as
pickles, which can increase the risk of another diet-related disease. Second, it can appear on labels of
some products (e.g., ketchup, relish, and fruit jams and jellies that must comply with compositional
standards set out in Division 11 of the current Food and Drug Regulations) for which a customary and
nutritionally desirable serving delivers only a very small amount of the beneficial ingredients.

9. For instance, a calcium/vitamin D-osteoporosis claim could appear on packages of
homogenized milk, ice cream, or cheeses if the following modified claim statement were used: A
healthy diet with adequate calcium and vitamin D, and regular physical activity, help to achieve
strong bones and may reduce the risk of osteoporosis. A serving of this food contains (naming
the percent)% of the recommended maximum daily intake of saturated fat. Adults who choose
foods lower in saturated fat may reduce their risk of heart disease. [proposed modification
bolded]

11. Foods that are eligible to make more than one claim on labels (e.g., most fruits and
vegetables) could either make all claims on each label or rotate the use of eligible claims. This
approach is analogous to warning labels that appear on cigarette packages except that, in this case, all
of the messages would be positive and would promote, rather than discourage, the sale of foods
bearing the label statement(s).